By Dr Tonia Mezzini
Changes in sexual desire are something many people experience throughout their lives, but for many women, a noticeable shift in libido can occur during perimenopause, menopause, or following cancer treatment.
Low libido is often talked about as though it is simply a loss of interest or something that happens with age. However, sexual desire is complex and influenced by many factors, including hormones, physical comfort, emotional wellbeing, relationships, stress levels, and overall health.
For those going through menopause or recovering from cancer treatment, changes in libido can be a very real and often distressing experience. Understanding why these changes happen is an important first step towards finding support and solutions.
How Menopause Can Affect Libido
During perimenopause and menopause, the body undergoes significant hormonal changes. As oestrogen levels decline, this can affect many areas of sexual health, including arousal, comfort, and desire.
Lower oestrogen levels can lead to changes in the vulval and vaginal tissues, including:
- Vaginal dryness
- Reduced natural lubrication
- Increased sensitivity or irritation
- Pain or discomfort during intimacy
- Changes in sensation
When intimacy becomes associated with discomfort or pain, it is completely understandable that desire may decrease. For some people, the issue is not a lack of desire itself, but rather that their body no longer responds in the same way it once did.
Testosterone also plays a role in sexual desire. While often associated with men, testosterone is a hormone produced by women too and contributes to libido. Levels naturally decline with age and may contribute to changes in sexual desire. But it doesn’t tell the whole story. Libido is complex and multifacted.
Menopause can also bring other challenges that indirectly impact libido. Sleep disruption, hot flushes, fatigue, mood changes, stress, and changes in body confidence can all influence how someone feels about intimacy.
How Cancer Treatment Can Impact Libido
For many cancer survivors, changes in sexual wellbeing can continue long after treatment has finished. Cancer treatment can affect the body in ways that influence desire, comfort, and confidence.
Some treatments may cause hormonal changes that mimic or trigger menopause, particularly treatments for hormone-sensitive cancers. A sudden drop in oestrogen can result in symptoms such as vaginal dryness, discomfort, and reduced sexual response.
Chemotherapy can also contribute to changes in libido through fatigue, nausea, pain, emotional stress, and changes to body image. For some people, treatment may lead to early menopause and the symptoms that come with it.
Radiation therapy, particularly when it involves the pelvic area, can cause changes to tissues, including dryness, sensitivity, scarring, or discomfort. Surgery may also impact sexual function through physical changes, nerve involvement, or changes in how someone feels about their body.
Beyond the physical impacts, a cancer diagnosis and treatment journey can be emotionally overwhelming. Fear, anxiety, uncertainty, and the process of adjusting to a changed body can all influence sexual desire.
Low Libido is not “Just in your Head”
One of the most important things to understand is that low libido is not a personal failure, and it is not something that should simply be accepted without support.
Sexual health is an important part of overall wellbeing, and changes in desire deserve the same attention and care as any other health concern.
Often, there is no single cause of low libido. It may be a combination of hormonal changes, physical symptoms, emotional wellbeing, medications, relationships, and life circumstances. Understanding the contributing factors can help identify the right approach.
Finding Support and Solutions
If changes in libido are affecting your confidence, relationships, or quality of life, it is worth having a conversation with a healthcare professional.
Support may include:
- Treating vaginal dryness or discomfort
- Exploring options to improve vulval and vaginal health
- Pelvic floor physiotherapy
- Addressing sleep, stress, and wellbeing
- Psychological support or sex therapy
- Reviewing medications and treatment-related side effects with your healthcare team
- Exploring your emotional libido
- Strengthening the erotic connection to your partner
For people who have experienced cancer, it is important to have these conversations with a healthcare provider who understands both sexual health and cancer survivorship.
You Deserve to Feel Comfortable and Confident
Menopause and cancer treatment can bring significant changes, but they do not mean the end of intimacy, connection, or sexual wellbeing.
Understanding what is happening in your body can help you feel more empowered and supported. Whether you are experiencing changes in desire, discomfort, or concerns about intimacy, seeking help is a positive step towards reclaiming your confidence and wellbeing.